Introduction to Mark Davis, ND:
Fecal Microbiota Transplant
As a student clinician at the National College of Natural Medicine, one of my mentors was Dr. Steven Sandberg-Lewis, an ND who specializes in treating people with inflammatory bowel disease. While doing research to help one of our patients, I stumbled across what is now known as Fecal Microbiota Transplantation (FMT, aka fecal transplant). In my research, it seemed like the only thing that UC patients could do that could potentially allow them to lead a completely normal lifestyle: no symptoms, no meds, no dietary restrictions.
Some people have success doing it at home, but others only have success with the more intensive supervision available in an in-patient setting. As far as I know, the only place offering it for UC patients at that time was the Center for Digestive Diseases in Sydney, Australia. They are the world leaders in this procedure, doing over 100 FMTs per year.
I wanted to make in-patient FMT available in the US, and my clinic is offering our first 5-day colon health retreat in January! In addition to daily FMT, I apply other interventions to control the pain and inflammation, and to increase the odds of the treatment lasting, including acupuncture, herbal medicine, some appropriate pharmaceutical interventions, and mind/body medicine techniques.
Feel free to email me if you have questions (firstname.lastname@example.org) or check out the website: FecalMicrobiotaTransplantation.com (or the easier-to-remember ProbioticInfusion.com)
Best wishes to all of you!
Mark Davis, ND
Hey UC’ers (It’s Adam Here, the colitis dude who tries to main the IHAVEUC website. I wrote several questions to Mark, when I saw his Colitis Venting Story Submitted, and he was kind enough to give some great answers to all of my questions about what he is involved with. Below are the questions I asked him, and his answers.
1: What is the success rate for people who use this type of therapy?
Well, first of all I should explain that this therapy has gone by a lot of different names in the past decade, including “fecal transplant,” “fecal bacteriotherapy,” and “human probiotic infusion,” but the new official name is “fecal microbiota transplantation,” or FMT. It’s mostly used for people who have C difficile colitis, and it’s about 90% effective for that. The world champion of using this technique for UC is a medical doctor named Thomas Borody, at the Center for Digestive Diseases in Sydney, Australia, and according to his published work, when he uses FMT for people with UC, he gets about a 50% success rate. By success, I mean drug-free, symptom-free, diet restriction-free people who have no evidence of UC when they get colonoscopy with biopsies. A small percent of people do relapse after years, but most are still symptom-free when they check back years or decades later. Among other studies Dr. Borody has published, there’s one from 2003 called “The treatment of ulcerative colitis using fecal bacteriotherapy” which highlights a 5-day technique using enema infusion, similar to what I’m offering. I’ve talked with Dr. Borody recently, and he says that since his published work, he’s refined the technique, and he claims a better than 90% success rate with UC patients. I haven’t been to his clinic, but I’m following his new protocols. I personally am very new to the technique, I have treated exactly one person with this therapy. The first time it didn’t work–if anything it flared her. The second time we set up a kind of retreat setting for her, and the treatment held, she was not cured but about 90% better. This inspired me to set up these retreats for people to come to, and I’m holding the very first one in late January. By the way, if you go to the “research” section on my website (probioticinfusion.com) you can look at the full text of that study I mentioned above.
2. What would be the average costs associated with moving forward with this type of therapy?
Well, anywhere from pretty much free to about $20,000, lol.
There have been UC sufferers who’ve taken poo from the diaper of a baby (child or grandchild), mixed it in a ziplock bag with some water, drawn it up into a bulb syringe, squirted it up their rear, and had almost immediate relief lasting up to 10 years! However, that method does not work for everyone. There are some people who don’t respond to that, but who do respond to treatment in a clinical setting. Why? Part of it may just be the context which allows you to lie horizontally for five days and retain the treatment. Part of it may be pharmaceutical management, which is part of what I offer. I should mention, Dr. Borody’s clinic prescribes 7-10 days of 2 or 3 powerful antibiotics preceding the FMT treatment, which I will not recommend to most people. Antibiotics are in my scope of practice, and I have prescribed them for people with very bad infections, but I don’t view UC as an infectious condition, I view it as an imbalance. As a naturopathic doctor, I provide some non-antibiotic pharmaceuticals, herbal treatments, acupuncture, specialized abdominal massage, personalized nutrition and mind/body medicine therapies during the retreat. My 5-day retreats cost $2600 if you bring your own donor (who must be screened for about $650 worth of lab test first) or $3500 if you want to use a donor from our pre-screened donor bank. The Center for Digestive Diseases charges different amounts for different people, but one UC patient reported spending $10,000 plus the cost of a ticket to Sydney, and one person estimated his total costs at $20,000. I break down what the costs are for on the “expenses” page of my website.
3. Does insurance cover any portion of this type of therapy?
As far as I know, no insurance company covers this.
4. How many patients has your clinic worked with so far, how many of them had UC?
I’ve worked with plenty of UC patients (a passion of mine), and suggested FMT to probably half a dozen, but–due to the “yuck factor” only one patient has taken the treatment so far. Now that I’ve set up these retreats (first one in January) I’m hoping to have the opportunity to treat a lot more people using this therapy.
5. Are there any situations where you would not recommend this type of therapy to a UC patient, if so, what ar the details for those cases?
If you are in a flare that is so bad that you might be seriously dehydrated, hypotensive, or severely anemic…I’m not an ER doc, I’m a naturopath, so I don’t want to treat people in emergency situations! If you’re having so much urgency and frequency that you couldn’t retain the treatments, there’s less chance of it working, although there are things I can do with pharmaceuticals, herbs, and nutrition to slow down the urgency and frequency, if you are already at the most stable level your gastroenterologist can get you to. In general, I will only work with someone who is already working with a gastroenterologist, and my preference is to send a letter to gastroenterologists after the procedure letting them know how the process has gone. Also, if someone wants to do the FMT retreat, I have them sign a release of records form so I can look at their previous medical records and confirm their diagnosis of UC.
6. What are some of the negative side effects that some patients might experience after the therapy?
Great question! There are no known negative side-effects. Interestingly enough, obese people with pre-diabetes who get FMT from lean donors with healthy blood sugar experience positive changes in their blood-work. Also, depressed rats who get FMT from happy rats get significantly happier, and some people who’ve had FMT for C difficile colitis have had their autoimmune and other diseases (MS, ITP, Parkinson’s disease) disappear, so donors from our donor bank are not only screened for infectious disease, but they are lean, healthy people with no mood disorders or history of autoimmune or other disease. See the reference page on my website for links to studies demonstrating all of the above.
7. Are there any long term potential side effects?
There are none known.
If you have any questions, feel free to leave comments below, Dr. Mark will get notified and will be able to respond directly on the website.